Background: Vitiligo is a multifactorial disorder characterized by a deficient or absent skin pigmentation because of melanocyte loss or inactivity in the basal layer of epidermis or mucosa. Numerous studies revealed that the complex interaction between genetic, environmental, biochemical and immunologic factors favours a loss of melanocytes in vitiligo. Cytokines found to have a significant role in pathogenetic process of the disease.
Methods: A case-control study enrolled 40 vitiligo patients and 40 healthy age- and sex-matched controls. VASI and VIDA were calculated. IL-27 and IL-37 were measured in venous blood samples using ELISA.
Results: Higher IL-27 level was detected among controls, however, higher IL-37 level was detected among patients. A statistically significant difference existed between patient and control groups regarding IL-27 and IL-37 (P<0.001). A statistically significant positive association between IL-37 and VASI and VIDA were detected while a non statistically significant negative relationship was noticed between IL-27 and VASI. Median IL-27 (ng/ml) in controls was 0.327 versus 0.095 in patients. Median IL-37 (pg/ml) was 21.99 among controls versus 277.56 among patients.

Conclusions: Cytokines have significant role in vitiligo onset and progression. They can act as biomarkers for identification of patients with progressive disease. IL-37 had important role in vitiligo pathogenesis as well an important predictor for vitiligo severity while IL-27 had immunomodulatory effects in vitiligo, no relationship was found between IL-27 values and patients' demographic data, disease severity and vitiligo type. IL-27 should be considered as a novel target for manipulation of the immune response in vitiligo.